Is Your Child Addicted to Computer Games?

School is out and the long summer stretches ahead. It should be a time for outdoor fun, playing with friends, baseball games, reading, craft projects and lemonade stands; but many children spend their summers glued to the computer, playing games on the Internet for hours on end. Gaming, which seems to be particularly appealing to males, can be addictive. While the subject is still under study, gaming seems to trigger compulsive behaviors in some people.

It can be difficult to tell whether a child’s competitive interest in gaming has crossed the line into internet addiction. The following warning signs can indicate a problem:

• Your child loses track of time while on the computer.
• He’d rather play computer games than play with friends or engage in other activities that have interested him in the past.
• You child neglects chores and other responsibilities.
• Your child lies to you about his computer use, changes the screen quickly when you walk into the room or sneaks computer time.
• He talks constantly about games, game personas and strategies.
• Your child becomes irritable or rebellious when told to turn off the computer.

Gaming and overuse of computers has been cited as contributing to feelings of social isolation and loneliness, particularly in teens. It can exacerbate anxiety and depression and may trigger obsessive compulsive behaviors. Experts fear that the sedentary aspect of gaming is contributing to an increasing array of physical health problems, like obesity, among U.S. children.

If you feel your child has a problem with computer gaming, you will have to help him modify his behavior:

• Monitor computer use. Keep the computer in a common area so you can keep track of Internet activity.
• Set clear limits for realistic computer use; for instance, allowing gaming for a set period of time each day.
• Talk to your child. Gaming can mask underlying issues like an inability to fit in at school, bullying, depression or other emotional problems.
• Help your child replace gaming with healthy activities such as team sports, scouts, hobbies and clubs. Encourage social interaction with peers.

If you don’t see improvement, your child may need professional psychiatric help to end his dependence on computer games. Cognitive-behavioral therapy can helping children successfully stop compulsive Internet behaviors and learn to live a happy, well-balanced life.

Internet Addiction Part 2

Some researchers still question whether problematic Internet use should be considered a disease. An argument against this is that the internet can be a means to satisfy other compulsive behaviors such as gambling, shopping, pornography use, etc. So it’s a medium of exchange to fuel other addictions and is not the source of the addiction. That is, if a person has a shopping compulsion and spends hours shopping on the Internet, they are “addicted” to shopping and not the Internet. Others will say that the Internet itself provides its own level of rewarding experience such that those addicted to the Internet use the internet simply for the experience of being online.

So, what’s wrong with enjoying being online? After all, there is a vast amount of information available over the Internet and it is easy to spend loads of time reading and surfing. How is this different from watching television? Although theoretically, the Internet could be seen as a better use of time than television because it can be a research tool providing useful information, it is the interactive nature of the Internet and the sheer volume of information available that makes it more dangerous to some than sitting in front of the television.

Unfortunately, we haven’t definitively established how much is too much. In a review article on problematic Internet use (source: Liu T, Potenza MN, CNS Spectr. Vol 12, No. 6, 2007), the author cites several studies where they used time as a measure of social and occupational impairment. In one study those considered to have an Internet addiction spent 38.5 hours/wk on the Internet for non-work related activities compared to 4.9 hours/wk for the non-problematic user.

How does one find 38 extra hours in the week to spend on the internet?

So how do you know if you spend too much time on the internet? Diagnostic criteria aside, I think the most practical way is to examine how much of an impact it has on your personal and work life. Are you less efficient at work, missing deadlines, being warned not to surf, being distracted in meetings because you’re thinking of what you’re going to surf next? Are you spending less time with friends, losing sleep because you’re up late on the Internet? Is your spouse or significant other threatening to throw away your Blackberry? Are you getting more headaches, neck pain or finger cramps because of too much time at your keyboard?

As for treatment, the Center for Internet Addiction Recovery is a web-based treatment that some have found to be very helpful (despite that it uses the Internet to treat an Internet problem). There are also some more traditional treatment centers that use an addiction model and 12 step recovery program. Some research has suggested antidepressants may be helpful.

Do You Have an Internet Addiction? Part 1

In Psychiatry we define addictions as habitual usage of something that creates physical and psychological dependence. Furthermore, when the activity is discontinued, the individual experiences withdrawal. Substances such as alcohol and drugs fall under this addiction model. When considering behaviors such as sexual activity, shopping, eating and more recently internet use, these behaviors don’t quite meet the biological model of addiction, but researchers have recognized that people can fall into a similar pattern of escalating the behavior while having trouble discontinuing it despite experiencing negative consequences. These behaviors can more broadly fall under impulse-control disorders.

The idea of a computer addiction first emerged in the 70’s and 80’s, however with the introduction of Broadband, it is now estimated that over 200 million people in the US use the internet. This equates to almost 70% of the population (source: Liu T, Potenza MN, CNS Spectr. Vol 12, No. 6, 2007). A few people have proposed criteria for diagnosing Internet Addiction as a disease entity.

The following is diagnostic criteria proposed by KS Young in an article published in Cyberpsychol Behav 1998; 11:237-244. A person must have 5 or more of these 8 criteria:

1. Is preoccupied with the internet (thinks about previous online activity or anticipates the next online session)
2. Needs to use the Internet with increased amounts of time in order to achieve satisfaction
3. Has made unsuccessful efforts to control, cut back or stop Internet use
4. Is restless, moody, depressed, or irritable when attempting to cut down or stop Internet use
5. Has stayed online longer than originally intended
6. Has jeopardized or risked the loss of significant relationship, job, educational, or career opportunity because of the internet
7. Has lied to family members, therapists, or others to conceal the extent of involvement with the Internet
8. Uses the Internet as a way to escape problems or to relieve a dysphoric mood (such as feelings of helplessness, guilt, anxiety, depression).

Young used the criteria for substance dependence as a model with some criticism as the behavior does not involve the physiological dependence I previously mentioned. Other researchers have developed more broad criteria, but Internet Addiction or Problematic Internet Use still has not been accepted into standard practice.

To be continued: